Floaters and Flashes (Video)

What are floaters?

You may sometimes see specks or clouds moving in your field of vision. These are called floaters.

You can often see them when looking at a plain background, like a blank wall or a blue sky.  In most cases, floaters are not serious but sometimes they can be a symptom of a retinal detachment, which requires immediate attention.

Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear gel-like fluid that fills the inside of your eye.

While these objects look like they are in front of your eye, they are actually floating inside it. What you see are the shadows they cast on the retina, the layer of cells lining the back of the eye that senses light and allows you to see. Floaters can appear as different shapes such as little dots, circles, lines, clouds or cobwebs.

What causes floaters?

Vitreous detachment

When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye. The vitreous gel pulls away from the back wall of the eye, causing a posterior vitreous detachment. This is a common cause of floaters.

Posterior vitreous detachment is more common in people who:

• are nearsighted
• have undergone cataract operations
• have had YAG laser surgery of the eye
• have had inflammation inside the eye

The appearance of floaters may be alarming, especially if they develop very suddenly.  You should contact your ophthalmologist (Eye M.D.) right away if you develop new floaters.

Are floaters ever serious?

The retina can tear when the shrinking vitreous-gel pulls away from the wall of the eye.  This sometimes causes a small amount of bleeding in the eye that may appear as new floaters.

Floaters may be a symptom of a tear in the retina, which is a serious problem.  If a retinal tear is not treated, the retina may detach from the back of the eye. You should see your ophthalmologist as soon as possible if:

• even one new floater appears suddenly
• you have a sudden onset of seeing flashes of light in your vision
• you lose your side vision

Can floaters be removed?

Floaters related to a retinal tear or detachment must be treated immediately.  Floaters associated with vitreous detachments are harmless and usually fade over time or become less bothersome, requiring no treatment.  Surgery to remove floaters is almost never required.  Vitamin therapy will not cause floaters to disappear.

Even if you have had floaters for years, you should schedule an eye examination with your ophthalmologist if you suddenly notice new ones.

What causes flashes of light?

When the vitreous gel rubs or pulls on the retina, you may see what look like flashing lights or lightning streaks.  You may have experienced a similar sensation if you have ever been hit in the eye and seen “stars.”

The flashes of light can appear off and on for several weeks or months.  As we grow older, it is more common to experience flashes.  If you notice the sudden appearance of light flashes, you should contact your ophthalmologist immediately in case the retina has been torn.

There are other causes of light flashes including migraine, with or without a headache, (see Topic Migraine for more information).

How are your eyes examined?

When an ophthalmologist examines your eyes, your pupils may be dilated with eyedrops.  During this painless examination, your ophthalmologist will carefully observe areas of your eye, including the retina and vitreous. If your eyes have been dilated, you will need to make arrangements for someone to drive you home afterward.

Floaters and flashes of light become more common as we grow older.  While not all floaters and flashes are serious, you should always have a medical eye examination by an ophthalmologist to make sure there has been no damage to your retina.